The authors pin-point seventy-six doctors who they determine were the medical elite of Montreal in the second half of the nineteenth century based on the doctors’ training, positions, titles and recognition. Of the group, more than half were Anglophones. Using the list of doctors from the prescription records of Montreal pharmacist H. R. Gray, which includes the names of a large majority of Montreal physicians of the time, the authors identify predominant physicians based on their visibility in the medical press. The authors point out that Montreal's medical elite was not a homogeneous group. In addition to the obvious linguistic division, the authors reveal other lines of stratification, clearly shown by the growing role of surgeons, a role enhanced by new techniques and operating procedures, and the beginning of medical specialization.